ABSTRACT
In the years 1991-2000, 6873 patients were operated at the Department of General, Oncological and Thoracic Surgery in Central Medical Hospital in Warsaw, due to cholecystolithiasis. Extrahepatic bile ducts were damaged in 9 patients. These lesions included: pointed damage with electrocoagulation, bile duct incision or sectioning and the resection of the main stem of bile duct. In 7 patients, the lesions were diagnoses intraoperatively and the conversion was performed. Two patients required laparotomy at later stage. As complications developed, some patients required relaparotomy. Two patients died due to multiorgan failure. The injury of extrahepatic bile ducts remains a dangerous, potentially life-threatening complication of cholecystectomy, irrespective of the operative technique applied.
Subject(s)
Bile Ducts, Extrahepatic/injuries , Cholecystectomy, Laparoscopic/adverse effects , Humans , Postoperative ComplicationsABSTRACT
Gunshot injuries of the trunk in the peace time are rare, but always represent great therapeutic and organisational problems. It concern especially thoraco-abdominal injury. Aim of this report is to present our treatment experiences with 19 wounded patients. Different procedure was applied. In 16 cases wounded laparotomy was done, in 4 cases following pleura cavity drainage. After that in 4 wounded thoracotomy was performed. In the 3 rest wounded thoraco-phrenolaparotomy was done. All of them had lung injury and a few of them have had great vessel and heart lesions. In the abdomen we found 1-4 organs injury. 7 (37%) wounded died, among these 6 after abdominal complications. Injuries mentioned above are severe, complicated and required individual and differentiated procedure. Above all severity of abdominal organs injury determined prognosis. Not enough experienced thoracic surgeon can cooperate with abdominal specialist surgeon during treatment procedure such a patients.
Subject(s)
Abdominal Injuries/surgery , Thoracic Injuries/surgery , Wounds, Gunshot/surgery , Adolescent , Adult , HumansABSTRACT
A 45-year-old male, with symptoms of many years standing of gastro-oesophageal reflux disease, was subjected, under general anaesthesia, to laparoscopic fundoplication. Tracheal intubation yielded no problems but great difficulties were encountered during tube insertion into the oesophagus. After surgery, aphonia developed. Laryngological examination demonstrated paralysis of the left vocal cord. Voice strength returned to the pre-operative status after 3 months, and laryngological examination confirmed normal mobility of both cords. The possible cause of the complication was damage to the left recurrent laryngeal nerve which occurred during insertion of the tube into the oesophagus. Gastro-oesophageal reflux disease causing 'acid laryngitis' can create conditions favouring this type of complication.
